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Cerebral angiography

Vertebral angiogram; Angiography - head; Carotid angiogram

Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.

Images

Brain
Carotid stenosis, X-ray of the left artery
Carotid stenosis, X-ray of the right artery

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How the Test is Performed

Cerebral angiography is done in the hospital or radiology center.

An area of your body, usually the groin, is cleaned and numbed with a local numbing medicine (anesthetic). A thin, hollow tube called a catheter is placed through an artery. The catheter is carefully moved up through the main blood vessels in the belly area and chest into an artery in the neck. X-rays help the doctor guide the catheter to the correct position.

Once the catheter is in place, the dye is sent through the catheter. X-ray images are taken to see how the dye moves through the artery and blood vessels of the brain. The dye helps highlight any blockages in blood flow.

Sometimes, a computer removes the bones and tissues on the images being viewed, so that only the blood vessels filled with the dye are seen. This is called digital subtraction angiography (DSA).

After the x-rays are taken, the catheter is withdrawn. Pressure is applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding or a device is used to close the tiny hole. A tight bandage is then applied. Your leg should be kept straight for 2 to 6 hours after the procedure. Watch the area for bleeding for at least the next 12 hours.

How to Prepare for the Test

Before the procedure, your health care provider will examine you and order blood tests.

Tell the provider if you:

You may be told not to eat or drink anything for 4 to 8 hours before the test.

You must sign a consent form. Your provider will explain the procedure and its risks. When you arrive at the testing site, you will be given a hospital gown to wear. You must remove all jewelry.

How the Test will Feel

The x-ray table may feel hard and cold. You may ask for a blanket or pillow.

Some people feel a sting when the numbing medicine (anesthetic) is given. You will feel a brief, sharp pain and pressure as the catheter is moved into the body.

The contrast may cause a warm or burning feeling of the skin of the face or head. This is normal and usually goes away within a few seconds.

You may have slight tenderness and bruising at the site of the injection after the test.

Why the Test is Performed

Cerebral angiography is most frequently used to identify or confirm problems with the blood vessels in the brain.

Your doctor may order this test if you have symptoms or signs of:

It is sometimes used to:

In some cases, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or CT scan of the head.

This test may also be done in preparation for medical treatment (interventional radiology procedures) by way of certain blood vessels.

What Abnormal Results Mean

Contrast dye flowing out of the blood vessel may be a sign of internal bleeding.

Narrowed arteries may suggest:

Out of place blood vessels may be due to:

Abnormal results may also be due to:

Risks

There is the possibility of complications, including:

Considerations

Tell your provider right away if you have:

Related Information

X-ray
Stroke
Tumor
Blood clots
Head CT scan
Aneurysm
Cerebral arteriovenous malformation
Aneurysm in the brain
Metastatic brain tumor
Neurosyphilis
Optic glioma
Pituitary tumor
Polycystic kidney disease
Brain tumor - children
Syphilitic aseptic meningitis

References

Kessel D, Robertson D. Interventional Radiology Survival Guide. 3rd ed. Philadelphia, PA: Elsevier; 2011.

Zenteno M, Vinuela F. Interventional neuroradiology: Neurological endovascular therapy in hemorrhagic and ischemic strokes. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 33E.

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Review Date: 10/22/2014  

Reviewed By: Jason Levy, MD, Northside Radiology Associates, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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